TY - JOUR
KW - Adolescent
KW - Adult
KW - Aged
KW - Anxiety Disorders/diagnosis/epidemiology
KW - Comorbidity
KW - Cross-Sectional Studies
KW - Depressive Disorder/diagnosis/epidemiology
KW - Diagnosis, Differential
KW - Family Practice/statistics & numerical data
KW - Feasibility Studies
KW - Female
KW - Humans
KW - Incidence
KW - Male
KW - Medicine/statistics & numerical data
KW - Middle Aged
KW - Outpatient Clinics, Hospital/statistics & numerical data
KW - Pilot Projects
KW - Primary Health Care
KW - Referral and Consultation/statistics & numerical data
KW - Somatoform Disorders/diagnosis/epidemiology
KW - Specialization
AU - B. J. Smith
AU - K. J. McGorm
AU - D. Weller
AU - C. Burton
AU - M. Sharpe
A1 - 
AB - OBJECTIVES: The study aimed (a) to test a method of identifying patients who have been repeatedly referred (RR) from primary care to medical outpatient clinics where they have received multiple diagnoses of medically unexplained symptoms (MUS) and (b) to describe the prevalence and characteristics of these patients. METHODS: RR patients with MUS (RRMUS) were arbitrarily defined as those with (a) five or more referrals in a 5-year period and (b) a specialist final diagnosis of MUS for at least three of these referrals. A two-stage method of identifying these patients was piloted in one primary care practice: Stage 1 used computerized health service data to identify RR; Stage 2 used manual case note review to identify referrals that ended with specialist diagnoses of MUS. The RRMUS patients identified were asked to complete a questionnaire, a psychiatric diagnostic interview, and their GPs were asked to rate how "difficult to manage" they were. RESULTS: The process was feasible and reasonably accurate. From 6770 registered patients aged 18 to 65 years, 23 (0.3%) were identified as RRMUS. They accounted for 157 referrals over the 5-year period. Sixteen agreed to further assessment, and 8 (50%) had a current anxiety or depressive disorder. GPs rated only 8 (50%) as "difficult to manage." CONCLUSION: This two-stage procedure offers a practical method of identifying RRMUS patients in primary care as a first step in achieving more cost-effective care. These patients have substantial psychiatric morbidity.
BT - Journal of psychosomatic research
C5 - Medically Unexplained Symptoms
CP - 3
CY - England
DO - 10.1016/j.jpsychores.2009.01.004
IS - 3
JF - Journal of psychosomatic research
N2 - OBJECTIVES: The study aimed (a) to test a method of identifying patients who have been repeatedly referred (RR) from primary care to medical outpatient clinics where they have received multiple diagnoses of medically unexplained symptoms (MUS) and (b) to describe the prevalence and characteristics of these patients. METHODS: RR patients with MUS (RRMUS) were arbitrarily defined as those with (a) five or more referrals in a 5-year period and (b) a specialist final diagnosis of MUS for at least three of these referrals. A two-stage method of identifying these patients was piloted in one primary care practice: Stage 1 used computerized health service data to identify RR; Stage 2 used manual case note review to identify referrals that ended with specialist diagnoses of MUS. The RRMUS patients identified were asked to complete a questionnaire, a psychiatric diagnostic interview, and their GPs were asked to rate how "difficult to manage" they were. RESULTS: The process was feasible and reasonably accurate. From 6770 registered patients aged 18 to 65 years, 23 (0.3%) were identified as RRMUS. They accounted for 157 referrals over the 5-year period. Sixteen agreed to further assessment, and 8 (50%) had a current anxiety or depressive disorder. GPs rated only 8 (50%) as "difficult to manage." CONCLUSION: This two-stage procedure offers a practical method of identifying RRMUS patients in primary care as a first step in achieving more cost-effective care. These patients have substantial psychiatric morbidity.
PP - England
PY - 2009
SN - 1879-1360; 0022-3999
SP - 207
EP - 211
EP - 
T1 - The identification in primary care of patients who have been repeatedly referred to hospital for medically unexplained symptoms: a pilot study
T2 - Journal of psychosomatic research
TI - The identification in primary care of patients who have been repeatedly referred to hospital for medically unexplained symptoms: a pilot study
U1 - Medically Unexplained Symptoms
U2 - 19686876
U3 - 10.1016/j.jpsychores.2009.01.004
VL - 67
VO - 1879-1360; 0022-3999
Y1 - 2009
ER -